Hanada M, Tokuda R, Ohnishi Y, Takeuchi N
Acta Pathol Jpn. 1984 Sep;34(5):1167-77. doi: 10.1111/j.1440-1827.1984.tb07644.x.
Two cases of spontaneous atheromatous embolization associated with unusual complications are presented. One is an 85-year-old man who developed an acute abdomen and underwent a surgical resection of totally infarcted left-sided colon. Histologically, multiple acute atheromatous emboli were found occluding the serosal and pericolic mesenteric arteries causing transmural necrosis of the involved portion of bowel. The other is an 80-year-old woman who had had a coronary heart disease, hypertension, and renal insufficiency, and terminally developed a rapid deterioration of renal function and melena. Postmortem examination showed a severely, ulcerated, aortic atherosclerosis and widespread, recurrent, atheromatous emboli in many abdominal organs with the resultant severe nephrosclerosis, gastrointestinal mucosal hemorrhagic necrosis, and multiple infarcts in the pancreas and spleen. In addition, there was focal cortical necrosis of the kidneys accompanied with glomerular capillary fibrin thrombi indicating disseminated intravascular coagulation (DIC). These findings seen in the present two cases were briefly discussed in light of the previous pertinent literature.
本文报告两例伴有异常并发症的自发性动脉粥样硬化栓塞病例。一例为85岁男性，出现急腹症，接受了完全梗死的左侧结肠手术切除。组织学检查发现，多个急性动脉粥样硬化栓子阻塞了浆膜和结肠周围肠系膜动脉，导致受累肠段全层坏死。另一例为80岁女性，患有冠心病、高血压和肾功能不全，最终出现肾功能迅速恶化和黑便。尸检显示严重的溃疡性主动脉粥样硬化，许多腹部器官广泛、反复出现动脉粥样硬化栓子，导致严重的肾硬化、胃肠道黏膜出血性坏死以及胰腺和脾脏多处梗死。此外，肾脏出现局灶性皮质坏死，并伴有肾小球毛细血管纤维蛋白血栓形成，提示弥散性血管内凝血（DIC）。结合既往相关文献对本两例病例的所见进行了简要讨论。
